background :
past 2 weeks i've been taking 20mg methylphenidate 4 times per day, it worked pretty good for 2 hours following each dose (but not every dose, was a little inconsistant sometimes) i only got 8-9 hours of treatment each day.
hence why i asked my psychiatrist if i could try a longer-acting medicine like concerta.
my body unfortunately does not absorb the medication as well as most people and i have to take from what i have come to realize "high doses" in order to get the normal positive result from these medicines... (methyphenidate at least so far, adderall was a failure)

doc RX'd me 2x54's to take in the morning, i told him i was concerned that my insurance wouldn't cover the extra dose per day, but there was no way for either of us to know if the larger dose would end up being covered or not. it wasn't covered, i payed almost 300 dollars for 60 concertas

DAY 1

doctor suggested i take one concerta on the first day and supliment it with my ritilins if i needed to.
i did research on concerta 54's and learned that 22% of the medicine is released in the first hour, and the rest at a slow pace throughout the next 6-10 hours.
22% of 54 mgs is only 11.8 mgs, which is half of the dose i've been taking four times per day for the past couple weeks, i then figured i would just go ahead and start w/ the two 54's on day 1 so that the first dose would be almost the same as my previous doses.

i took both @ 10:30 am (woke up late today)
took 45 minutes to feel any changes, and it so far has been very different from how my body reacted to each 20mg ritalins (generic)
i feel lazy
i feel tired
i feel my face just going into a exausted looking expression and i cant help it
i feel a strange sensation in my body that i know is the medicine, but its hard to describe it, it doesn't feel "good" necesarily, not "bad" either, but its different, like my cells are getting engery but not my brain, and thus not any brain-to body muscle stimulation... seems more the opposite like even my normal un-medicated brain-to-periphrial body movement is lessend??? weird.
i have been concentrating a lot on my comuter (which is normal if i'm looking at what i'm interested in) but because my body feels stuck and lazy i guess it seems like i'm more focused than usual.

so far, i'm not impressed and very dissapointed! :(
i spent way too much money on this medicine, i wish i had only paid for 30, but i really thought this medicine was going to work just as well as the generic instant release ritalins, if not better because of no drastic "dips" and rebounds that come between ritalin doses...
WHAT THE HELL
i don't know this for sure, but i bet pharmacies don't accept returns huh??? hahaha.......ugghhhh!

I recently started my ADD med search on Ritalin. 20mg X1 only lasted about 2-3 hours, so I went with X2. Made me want to kill everything! Irritability was rediculous!!
Switched to Concerta 54mg X1 for the last 10 days and feel exactly as you describe. I'm going to finish a full 2 weeks, but if it doesn't change, I'm getting off this depression ride. I've never felt so lazy, isolated, and depressed in my life.
Sorry you spent so much on this stuff. It isn't working for me. Hopefully it changes for you.

Ritalin alone did the same for me. Concerta is better absorbed if it does not get impeded by any accidental ascorbic acid intake. However, ritalin 2x and coffee, every 1 hour before meals, and good and balanced nutrition, which contains enough fatty acids and protein, makes ritalin work. It never worked better for me before I started taking zoloft. I guess, an SSRI is a must, or you should be careful about your brains serotonin condition. Maybe dopamin and serotonin imbalanca might cause more anxiety and agitation than relief.

ok its been almost 5 hours since my dose of 2 54mgs, about an hour ago i started getting a familiar sensation- chest wall tightness/stiff neck/shortness of breath

i used to get this on wellbutrin ir 5 years ago, also when i had short phases of daily panic attacks, i got it a few times when i was taking adderall (which sedated me), i got this twice on the ritalin but were days when drank coffee,
this suuuuucks

i am calm and totally lazy. i know what the chest tightness is so i'm not going to flip out, might take half of an old valium...
my heart rate is consistant and beating at a normal speed...
it totally feels like my chest wall muscles are spasming (but staying constricted)

i think i'll call my doc at tell him i don't want to keep taking this medicine and just go back to taking the rest of my generic methylphenidates until my next appointment, which i would rather have sooner than later... what an enormous waste of money

how the hell is it that i get a good reaction from 20mg generic methyphenidates (methylin) but an opposite reaction from concerta methylphenidates????
2 54mgs = 22mg initial dose of methylphenidate, and the rest is a slow release of the rest over 8 or so hours, so the dosaging is viturally equivalent to the 20 mg gen. ritalins,

???????????????????????????

this is crazy

I take 2 54's of concerta because I was a high dose responder and had the exact same side effects as you stated. Normally , I would take ritalin and be able to calm down and focus but when I took two concerta I felt , tired , irritable and sluggish , it was as if I was in third gear. I'm not sure why and I don't care to research about all the millions of ways ( acidic aborbtion or anything else that could lead to false positives of why it's not working like the ir tabs work. Oh and the ir tabs work fine.

oh and by the way I will state that I have acid reflux, it was so bad that in high school I couldn't eat at all, so now I've been taking prevacid for my reflux for 7 years. Who knows maybe this affects the absorbtion, but regular ritalin ir tabs still work . Makes zero sense and kind of makes me angry as well. They should work identically but in my case they don't .

hey hollywood-
i am really glad there is someone on here that has experienced this particular problem! i was expecting to be a lone wolf with the "high-dose responding " as it seems like 99% of the members on here respond perfectly to the "normal" dosage ranges....

so you are back on ritalin irs now???
how many per day do you take and how long do they last????
(i'm assuming u are taking 20mg'ers)

if i were to get my ideal amount of the day coverage with the effects that ritalin ir's were having (and taking into consideration their positive effects lasting 2 hours) i'd be taking one every 2 hours starting at 9 am and last one @ 10pm so that i can go to bed @ my normal midnight/1am-ish (i slept really good while on ritalin ir, so insomnia isn't an issue) but what IS an issue is the crazy pms-like irritability and hard-hitting fatigue when the ir's effect runs out.... (hence 10pm dose)
this would mean if i were to go back to ir's, 7 doses per day??? is this unheard of or are there people out there on similar dosing schedules?

i am in college and a mother and need FUNCTIONING HOURS from waking up in the morning until going to sleep at night- i tend to sit on my *** and zone out after my meds wear off, and during the time in the morning when i have been postponing taking my meds so i don't crash in the early evening (because only allotted 4 per day before)
is this an unreasonable desire? do doctors (adhd specialists) commonly understand this need to have functioning awake-hours and are willing to adjust treatment plans to acomidate this???
i feel like i'm not supposed to want to feel normal from waking until bedtime- like i'd be breaking a rule or something???

Umm.. no taking the ir's every two hours or so does seem about right when you start running into long days and have to pay attention to detailed work like college. I remember back at arizona state that I had a doctor give me 20's , 10's and 5's in bulk and he told me to take them every 2.5 hours . The ir's always work well but I do remember dosing around 3-6 times per day . It can be a real hastle. I think for all intents and purposes that the adderall ir tabs are better only because with adderall the more you take the longer the drug lasts in your systyem unlike mph. Yet, to answer your question no thats really not weird, and it must be the way concerta hits you that messes things up-

yeah i started w/ adderall and it gave be the same sedated nasty feeling- i did notice it took about 4/5 hours for the ir 20s to wear off... i wish methylphenidate would last that long in the ir form too :(

i have kind of concluded that i want to steer clear of drugs that are similar in chemical makeup to adderall...

theres got to be something that is as effective as ritalin that is generic ($$), that i wouldn't have to take every 2 hours, and that the dose i need isn't off the spectrum of normal doses and mgs .....

i'm now afraid of long acting meds, irrational? yes a little considering all work differently with each person

still feeling gross, its 10pm so its been about 12 hours... i'm not feeling as debilitated as i did earlier in the day thank god

No worries , I've run into the same problem with the xr's . What I'm saying is in the past with the xr's I've always first off never felt that initial boost ( which in my case helps fight my adhd it has nothing to do with looking for an energy boost, I honestly don't care to look for things , all I'm looking for is normal thought just like my peers and friends have naturally and luckily ritalin has always brought me to their level so I could interact just like everybody else). When I first tried concerta a while back it was and never has been consistent , sometimes it worked well but never was reliable as the regular ritalin ir tablets have been. Regarding adderall are you saying that you've tried the ir adderall tablets? If you have I have too and I have to say that with adderall coming from mph it seems you have to give it a few months to kick in , I swear adderall didn't do a thing for me until like two straight months of not thinking about it and taking it daily and staying positive , then one day ( bang) it worked and it worked far better than mph ever has. I think your body really has to adjust from going from one substance to another, and for all intents and purposes adderall + wellbutrin has always worked well together ( again you have to keep at the two for atleast 5 weeks or so.... In conclusion, it may be that the xr's have a therapeutic effect for us high dose responders for 4-5-some 8 hours but I think that the medication stays in your system unlike the ir tablets and thats when you start feeling drowsy, sedated, or sluggish while you keep taking the xr formulations....What I'm saying is that it stays in your system just long enough to run down your body and thus making you more tired and run down and of course throwing your adhd in the pitts of hell making you far worse with every day. Basically you should just go back to what works then with a clear brain if you like you can start to rethink options....As for me maybe it's absorption issues with concerta, maybe taking prevacid for years has screwed with the way xr meds are released...etc, etc, etc. One things for sure ir ritalin tablets work great and they work better every day that I progress since concerta has been in my system ......

With concerta even though the total daily dosing is the same you are not getting as high blood/plasma values compared to Ritalin IR. Concerta by design was made for slow, steady dosing by taking the 'middle ground' compared with the fast high and fast lows that Ritalin IR gives.
You might want to check Ritalin LA or Metadate CD instead of Concerta. Ritalin LA gives two equal doses (50/50) of Ritalin 4 hours apart. Metadate CD gives a 30/70 split.

J

JR-

Good point, no use overthinking or getting angry with concerta. I'll ask my doc about the ritalin L.A

No worries , I've run into the same problem with the xr's . What I'm saying is in the past with the xr's I've always first off never felt that initial boost ( which in my case helps fight my adhd it has nothing to do with looking for an energy boost,
yeah i did not notice any initial boost yesterday w/ the 2 54's, which makes me think that even this "22%" that is supposed to be "instantly released" is probably still much slower than regular ir tabs- i definitely should have felt the initial "22%" ...
i agree with you and think that the boost for the morning dose is essential, after going several hours with everything leaving our system, we probably are still in a "rebound" state upon waking, which for me, is just making my normal "grumpy/slow" mornings even worse...
I honestly don't care to look for things , all I'm looking for is normal thought just like my peers and friends have naturally and luckily ritalin has always brought me to their level so I could interact just like everybody else).
i felt more normal on ritalin, HOWEVER i did noticed i was a little more anti-social at times, but not all the time, this may be some anxiety, but i'm always having fits of anxiety in my normal state so i dont know never mind lol
When I first tried concerta a while back it was and never has been consistent , sometimes it worked well but never was reliable as the regular ritalin ir tablets have been.
well i am cringing at the thought of trying concerta again- i felt like i took a benedril that lasted 12 hours! i suspect my dose was being released slowly thus too low- but theres no way i could afford this medicine in the future- and more than 108mgs just seems like a curse money wise!!
Regarding adderall are you saying that you've tried the ir adderall tablets?
yeah started with 10mgs 4xday- practically no benefits and felt like my normal spacey/lazy self...
then after 2 weeks switched to 20mgs 4xday, no benefits and felt sedated all the time... i also was getting the anxiety symptom of chest-tightness which made me have to lay down and meditate to get it to stop
If you have I have too and I have to say that with adderall coming from mph it seems you have to give it a few months to kick in , I swear adderall didn't do a thing for me until like two straight months of not thinking about it and taking it daily and staying positive , then one day ( bang) it worked and it worked far better than mph ever has.
i cant imagine staying on adderall for that long... it was debilitating me... i thought that with stimulants you generally know if they are going to work as soon as a few days to a week????? i see how antidepressants take a while, and i guess i do see how it MIGHT be possible for your body to adjust to a stimulant and begin processing it in a beneficial way, i just don't think its commonly suggested that people wait months for results... especially when all you get is side effects...
I think your body really has to adjust from going from one substance to another, and for all intents and purposes adderall + wellbutrin has always worked well together ( again you have to keep at the two for atleast 5 weeks or so....
yeah i take wellbutrin too, 300 xr, i've taken it off and on for years, and after trying many other antidepressants it's the ONLY one that has ever lifted my depression... back when i was taking the wellbutrin ir's i would get panic attacks, i think wellbutrin tends to trigger anxiety issues with me which seems to have evened out with the XR
In conclusion, it may be that the xr's have a therapeutic effect for us high dose responders for 4-5-some 8 hours but I think that the medication stays in your system unlike the ir tablets and thats when you start feeling drowsy, sedated, or sluggish while you keep taking the xr formulations....
perhaps you are right when the xr's start at the proper dose- but yesterday i felt sedated from 45 minutes-on till i went to bed.... anxiety(only chest tightness) started @ 5 hours in which i read somewhere indicates that the anxiety is caused from the rebound of the medication leaving your system... i don't know...
What I'm saying is that it stays in your system just long enough to run down your body and thus making you more tired and run down and of course throwing your adhd in the pitts of hell making you far worse with every day. Basically you should just go back to what works then with a clear brain if you like you can start to rethink options....
yeah thats what i'm planning to do until my next appointment, just will have to deal w/ only getting 8 hours of normalcy w/ 4 irs :(
i just really don't think taking 6 irs a day is indicative of a medicine that works- ???? umm yeah even though i get cognitive benefits from it, does this make sense???
and wouldn't u think i'd get immune to it after 20 mgs every two hours ???

With concerta even though the total daily dosing is the same you are not getting as high blood/plasma values compared to Ritalin IR. Concerta by design was made for slow, steady dosing by taking the 'middle ground' compared with the fast high and fast lows that Ritalin IR gives.
You might want to check Ritalin LA or Metadate CD instead of Concerta. Ritalin LA gives two equal doses (50/50) of Ritalin 4 hours apart. Metadate CD gives a 30/70 split.i think you hit the nail on the head with the big difference between ritalin ir and concerta! i bet concerta is more successful with those who weren't switching over from ritalin irs...

i looked up ritalin LA and i like the idea of 2 full doses like taking two ir's in one pill! but it looks like if the highest mg is 40 thats 20mgs 4 hours apart??? see i have been needing 20 mgs 2-2.5 hours apart :rolleyes:
then i looked up the methylin er, that seems to be made for little kids- 20 mg is the highest pill mg and is supposed to last 8 hours?? umm no thanks

Methylin er is for youngsters. Look up Metadate CD, it goes up to 60mg capsules

http://www.ucb-group.com/documents/MetadateCDPI.pdf

J

MissT-

I can honestly tell you that I've experienced verbatim the exact reactions that you have had with the xr medication. To answer one question regarding taking the ritalin 6 times daily , if it works then no I see absolutely no problem at all with taking them to help you function just like everybody else. It's not like having adhd without medication is even close to being useful in everyday scenarios. Ritalin LA may be an option, you could try that out and add some boosters ( say ritalin 10's ) to supplement your dosages with. I think ritalin 10's have been the best for me , although I require atleast 20-30mg for the benefit , I like to have the option of not taking as much when the day is winding down. Additionally, I think your anxiety or atleast any that I've ever had is only when like you stated the meds are leaving the body and your rebounding, usually I'm in the gym working it off so I really don't care but that's what I think it could be-
Also , at times when your focusing really hard to one thing ritalin can cause me to be quiet but look around aren't all the other people quiet that are working at getting something done? Additionally, I think that down the road wellbutrin potentiates the effect of ritalin , therefere easing rebounds and some times giving the benefit of not having to take as much ritalin. From this post I've gained insight, I cut concerta , and feel normal again - Oh ritalin la with boosters sounds like a good idea, focalin isn't bad either -